UNNECESSARY ARTERIAL DOPPLER EXAMINATION OF THE LEGS. CLINICAL DECISION RULES MAY HELP?

Health resources consumption depends mainly on physicians prescription habits. We identified reduction of unnecessary prescribed lower limbs arterial Doppler examinations as an area of potential cost control and quality improvement. We designed therefore a screening method based on clinical decision...

Full description

Saved in:
Bibliographic Details
Published in:International journal for quality in health care 1991-06, Vol.3 (2), p.115-122
Main Authors: Marcon, G., Barbato, O., Scevola, M., Bettin, M. G., Zolli, M.
Format: Article
Language:English
Citations: Items that cite this one
Online Access:Get full text
Tags: Add Tag
No Tags, Be the first to tag this record!
Description
Summary:Health resources consumption depends mainly on physicians prescription habits. We identified reduction of unnecessary prescribed lower limbs arterial Doppler examinations as an area of potential cost control and quality improvement. We designed therefore a screening method based on clinical decision rules derived from epidemiological considerations: study of our records showed that patients with normal clinical examination and low risk factors score could be considered free from arterial disease by clinical grounds only, and that patients with normal clinical examination and very high risk score needed an extensive noninvasive evaluation. By offering a screening clinical examination (needing a working time shorter than a Doppler examination) with short waiting lists, we were able to safely exclude many normal patients from extensive Doppler examination, improving effectiveness by reducing total examination time by 22% and service quality by a Doppler examinations scheduling based on clinical severity judgement.
ISSN:1353-4505
1464-3677
DOI:10.1093/intqhc/3.2.115